title: Spread of non-typable multiply resistant Haemophilus influenzae in a South African hospital.
abstract: In July 1987 non-typable Haemophilus influenzae strains resistant to both ampicillin and chloramphenicol were isolated from the endotracheal aspirate of two children with pneumonia at Baragwanath Hospital, Johannesburg, South Africa. A study was therefore undertaken to determine the carriage rates of Haemophilus influenzae strains in the nasopharynx of children and staff in the index ward and in three control wards. Using a disc diffusion and an agar dilution method the susceptibility was determined of 100 isolates to ampicillin, chloramphenicol, erythromycin, rifampicin, amoxicillin/clavulanic acid, gentamicin, cefaclor, cefotaxime, tetracycline, sulphamethoxazole, trimethoprim and trimethoprim/sulphamethoxazole (1:19). The overall carriage rate of Haemophilus influenzae on admission was 76%. In the index ward, children carrying multiply resistant strains differed from the other children in that there was a longer mean duration of hospitalization, a lower proportion of males, and a higher proportion who had previously received antibiotics. All ampicillin resistant strains were shown to produce beta-lactamase. Only four isolates belonged to serotype b, of which three were ampicillin resistant and chloramphenicol sensitive while one was resistant to both drugs. Nasopharyngeal spread of resistant non-typable strains of Haemophilus influenzae was demonstrated to affect the management of paediatric patients in the hospital.
authors.affiliation: Department of Medical Microbiology, School of Pathology, South African Institute for Medical Research, Johannesburg.
authors.forename: C
authors.initials: C
authors.lastname: Heney
authors.forename: F
authors.initials: F
authors.lastname: Berkowitz
authors.forename: T
authors.initials: T
authors.lastname: Baise
authors.forename: M
authors.initials: M
authors.lastname: Cotton
authors.forename: M
authors.initials: M
authors.lastname: Khoosal
authors.forename: S
authors.initials: S
authors.lastname: Vally
authors.forename: R
authors.initials: R
authors.lastname: Barriere
authors.forename: J
authors.initials: J
authors.lastname: Saunders
authors.forename: H J
authors.initials: HJ
authors.lastname: Koornhof
mesh_terms: D000668:Ampicillin Resistance; D002648:Child; D002702:Chloramphenicol Resistance; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D006192:Haemophilus Infections / Q000453:epidemiology* / Q000382:microbiology; D006193:Haemophilus influenzae / Q000187:drug effects / Q000302:isolation & purification; D006748:Hospital Departments; D006801:Humans; D010372:Pediatrics; D013019:South Africa / Q000453:epidemiology